1. CS is most commonly secondary to a large MI where > 40% of the myocardium is involved; however mechanical, valvular, dysrhythmogenic, and infectious etiologies should also be considered: papillary or chordal dysfunction, free wall or septal defects disease, insuffiency of any valve, myopericarditis, endocarditis, Tako-tsubo, end stage cardiomyopathy, and tamponade. 2. Incidence of 5-10% STEMI and 2.5-5% NSTEMI 3. Mortality ~50% 4. Immediate coronary reperfusion is the best treatment (NNT 8). Medical therapy is a distant second choice in management, with reperfusion and pressors as needed. Early intra-aortic balloon pump use is key. 5. Recent case reports have shown imporved outcomes when induced hypothermia was used in patients refractory to traditional therapy with pressors/inotropes/IABP.
